Pediatric emergency care
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Pediatric emergency care · Nov 2020
Multicenter Study Observational StudyThe Association of Glasgow Coma Scale Score With Clinically Important Traumatic Brain Injuries in Children.
An accurate understanding of the incidence of clinically important traumatic brain injuries (ciTBIs) based on presenting Glasgow Coma Scale (GCS) scores in pediatric patients is required to formulate a pretest probability of disease to guide testing and treatment. Our objective was to determine the prevalence of ciTBI and neurosurgical intervention for each GCS score (range 3-15) in children presenting after blunt head trauma. ⋯ A nearly linear relationship exists between the initial GCS score and ciTBI in children with blunt head trauma. The highest prevalence of ciTBI and neurosurgical intervention occurred in children with GCS scores of 4. Children presenting with GCS scores of 14 had a nonnegligible prevalence of ciTBI. These findings are critical to providers caring for children with blunt head trauma to accurately formulate pretest probabilities of ciTBI.
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Pediatric emergency care · Nov 2020
ReviewCurrent Approach to the Evaluation and Management of Incomplete Kawasaki Disease in the Emergency Department.
Kawasaki disease (KD) is one of the most common vasculitides of childhood and frequently presents to the emergency department. Although the diagnosis of KD is based on clinical criteria, children who do not fulfill the criteria but have sufficient supportive features of KD are diagnosed as having incomplete KD and warrant the same course of therapy as children with classic KD. The diagnosis of incomplete KD is challenging and requires a high index of suspicion. The purpose of this article is to review presenting features of incomplete KD and the diagnostic approach and management of children in the emergency department.
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Pediatric emergency care · Nov 2020
Improving Time to Antibiotics for Pediatric Oncology Patients With Fever and Suspected Neutropenia by Applying Lean Principles.
Fever in the setting of neutropenia is a potentially life-threatening complication of cancer treatment. A time of less than 60 minutes from presentation to antibiotic administration is therefore recommended. ⋯ Lean methodology effectively identifies barriers and provides solutions to remove barriers and improve administration of antibiotics in febrile oncology patients. These can be widely applied, including in smaller institutions with minimal increased utilization of resources.